List the person's name who will be traveling and the nature of business to justify the cost. Attach copy of the program, agenda, and/or registration form.

List all other personnel, by name or list.

Method of transportation requested: The costs of the method of transportation requested are:

Car - 5 passenger .30 cents/mile,

7 –passenger minivan .38 cents/mile,

12-passenger van .55 cents/mile

4-wheel drive pickup 5 passenger .47 cents/mile

9-passenger suburban .51 cents/mile

8-passenger cart; no cost

Indicate estimated number of miles by each vehicle. If you are traveling by air include methods of transportation to the airport. Purchase order can be issued for plane ticket if travel agency where arrangements have been made as indicated and departmental requisition is submitted.

Estimated cost of transportation, meals, and lodging must be filled in.

Black rectangle: The department head must initial the appropriate line concerning who assigned travel.

If travel is out of state and lodging will be in excess of $150.00 plus tax per night initial the box labeled Excess lodging requested. See current regulations for limits of excess lodging.

Registration fee/taxi fee/incidentals should be listed to cover miscellaneous expenses. A typed department requisition and registration form should accompany travel request if registration is by purchase order.

Total amount allowed for state/local account and state/local account number should be amount/account from which this travel will be paid.

Grand total amount is for state/local accounts, that will be the amount allowed.

Requesting party: Signed by the person making the trip.Supervisor: Signed by requesting party immediate supervisor.Administrative Officer (BHSU Vice-President): Signed by senior level university officer.President: Signed by University President or the President’s Designee for out-of-state travel only. The Facilities Services Office will assign or approve a state vehicle for someone to take their personal car if a state car is not available and reimbursement will be at $.37 per mile. If someone requests to take their own personal car reimbursement will be at $.20 per mile unless written justification is attached, and approved by the Vice President for Finance & Administration. Requesting party must have a valid drivers license if state vehicle is requested. Facilities Services can request proof of license prior to issuing vehicle. An email with the approved travel request attached will be sent to the requesting party or respective department.